About Mass NAELAElder law attorneys concentrate on issues that concern older individuals and their families. One of the most common concerns presented to elder law attorneys is the wish to avoid complete impoverishment if long-term care is needed. In addition to helping protect assets from nursing home expenses, elder law attorneys:
Attorneys who work primarily with the elderly appreciate the complex financial and social realities and are able to address their clients' legal issues in a comprehensive way. They often work with other professionals such as accountants, financial planners, and geriatric care managers to ensure a coordinated plan.
The prospect of long-term care in a nursing home is one of the most difficult and unpleasant experiences facing elders and their families, creating stress and anxiety about the quality and high cost of care. In Massachusetts, nursing home care averages $65,000-$100,000 per year. While Medicare and supplemental health insurance plans cover most of the medical expenses of an acute illness, they provide only minimal coverage of nursing home care. Unless long-term care insurance was previously purchased, the only program available to assist in financing nursing home care is Medicaid (now known as MassHealth in Massachusetts), which is a joint federal-state public benefits program having a complex set of eligibility rules. What are the Medicaid Eligibility Rules?
More detail about nursing home Medicaid rules. Asset Limits To qualify for Medicaid coverage of nursing home care, a single individual cannot own more than $2,000 in "countable assets." Ordinarily a couple cannot own more than $89,280* (plus $2,000 allowed to the institutionalized spouse), except when the spouse at home has income below certain specified amounts or has very high shelter expenses. In these cases, it may be possible to retain additional assets to protect the spouse at home and still qualify for Medicaid. The home does not have to be sold to qualify for Medicaid. It is a "noncountable asset" as long as the Medicaid application is completed correctly. Once qualified for Medicaid, the nursing home resident must use his or her income, after certain deductions, to pay for the nursing home. Medicaid pays the rest. The spouse at home does not have to pay any of his or her income to the nursing home. Sometimes, depending upon a number of factors, some of the income of the nursing home resident can be kept for the spouse at home. Have you made gifts within the past 36 months? Medicaid reviews all financial records for the 36 months prior to application (60 months in certain cases involving trusts). The purposed of this "look-back" period is to determine if any transfers were made which might disqualify the applicant from receiving benefits. A disqualifying transfer will exist if during this period the applicant or spouse transferred a countable asset or the principal residence for less than fair market value. Not all gifts cause a 36-month disqualification! The amount of the gift determines the length of disqualification and data of eligibility. Also, in special circumstances the gift causes no disqualification at all! Sometimes, a carefully planned program of disqualifying transfers can be of long-term benefit to the nursing home resident, his or her spouse, and family. Such gifting should, however, only be undertaken with the advice and assistance of an elder law attorney. Are you filing for Medicaid before determining your legal rights? The Medicaid application process is lengthy and cumbersome. As a result, some nursing homes contract with private companies to prepare Medicaid applications for residents. Medicaid application companies usually provide their services at no or low charge to the Medicaid applicant. However, these companies generally represent the nursing home or hospital, not the Medicaid applicant or his/her family. These companies are not attorneys, and do not give legal advice. They merely assemble and file the actual Medicaid application. Without an attorney/individual client relationship, financial information may be shared by the application company with the nursing home and/or the hospital which has hired the company. If excess assets are discovered, the application company will inform the nursing home or hospital, and you will be expected to continue paying the facility with these assets. Since the application company does not provide legal advice, it will not inform the family of alternative legal ways of using or preserving excess funds. The Medicaid applicant may therefore lose opportunities to preserve assets. Even if your relative is already in a nursing home, options may exist to preserve remaining assets for your family. Don't be penny-wise and pound-foolish! You may save money on the application but lose your house or life savings in the process. How can I find an Elder Law Attorney? Most elder law attorneys are members of the National Academy of Elder Law Attorneys (NAELA), a non-profit association of over 4,000 attorneys specializing in legal issues affecting the elderly. The Massachusetts Chapter of NAELA is one of the most active chapters nationally, with more than 400 member attorneys. To find a Massachusetts elder law attorney near you, search the national database online. Visit the NAELA web site at www.naela.org. *2002 adjusted annually |
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